Wen Wei, Chi Yi, Liu Mingwang, Gao Mengjie, Xie Beili, Yan Yuxin, Jin Zhidie, Jiang Lulian, Zhang Yiqing, Chen Keji, Zhao Fuhai
Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
The People's Hospital of Xianqzhou District, Zhuhai, China.
Sci Rep. 2025 Jul 2;15(1):22694. doi: 10.1038/s41598-025-08057-4.
Coronary microvascular disease (CMVD) is associated with abnormalities in glucose-lipid metabolism. And the triglyceride to high density lipoprotein (HDL) (TG/HDL) ratio can be used to characterize levels of glycolipid metabolism. Therefore, it is hypothesized that increased TG/HDL may trigger CMVD. This study enrolled patients with angina pectoris but negative coronary angiograms to explore inflammatory factor-mediated disorder of glycolipid metabolism triggers CMVD. Logistics regression model and subgroup analysis were constructed to explore the associations between TG/HDL and CMVD. Restricted cubic splines were applied to further the associations of TG/HDL with CMVD. Given inflammatory factors as intermediary factor, we investigate the mediating effects of TG/HDL on CMVD. 242 patients were eventually recruited and 150 patients were diagnosed with CMVD. In the multivariable-adjusted model, TG/HDL and inflammatory indexes including the C-reaction protein (CRP), C-reaction protein to lymphocyte ratio (CLR) and inflammatory burden index (IBI) were positively related to CMVD (Odds Ratio (OR) = 1.71, 95% CI = 0.69-4.25; OR = 1.89, 95% CI = 1.32-2.68; OR = 2.76, 95% CI = 1.56-4.89; OR = 1.22, 95% CI = 1.08-1.37, respectively). Mediation analysis indicated that CRP, CLR and IBI mediated 26.37%, 16.89% and 10.45% of the association of TG/HDL with CMVD. TG/HDL is positively associated with CMVD. And this association appeared to be partially mediated through inflammatory indices.
冠状动脉微血管疾病（CMVD）与糖脂代谢异常有关。甘油三酯与高密度脂蛋白（HDL）的比值（TG/HDL）可用于表征糖脂代谢水平。因此，有假设认为TG/HDL升高可能引发CMVD。本研究纳入了冠状动脉造影阴性的心绞痛患者，以探讨炎症因子介导的糖脂代谢紊乱是否引发CMVD。构建逻辑回归模型和亚组分析以探讨TG/HDL与CMVD之间的关联。应用受限立方样条进一步分析TG/HDL与CMVD的关联。以炎症因子作为中介因素，我们研究了TG/HDL对CMVD的中介作用。最终招募了242例患者，其中150例被诊断为CMVD。在多变量调整模型中，TG/HDL以及包括C反应蛋白（CRP）、C反应蛋白与淋巴细胞比值（CLR）和炎症负担指数（IBI）在内的炎症指标与CMVD呈正相关（比值比（OR）分别为1.71，95%置信区间（CI）为0.69 - 4.25；OR = 1.89，95%CI = 1.32 - 2.68；OR = 2.76，95%CI = 1.56 - 4.89；OR = 1.22，95%CI = 1.08 - 1.37）。中介分析表明，CRP、CLR和IBI分别介导了TG/HDL与CMVD关联的26.37%、16.89%和10.45%。TG/HDL与CMVD呈正相关。并且这种关联似乎部分是通过炎症指标介导的。
